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Organization
RELIABLE PHARMACY OF WISCONSIN LLC
Active
Organization
RELIABLE PHARMACY OF WISCONSIN LLC
Active
Other names
Reliable Pharmacy of Wisconsin
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA CERNAK (OWNER)
(262) 565-6353
Entity
Organization
Contact information
Practice address
10105 74TH ST STE 102, KENOSHA, WI 53142-7519
(262) 909-5685
(262) 925-8409
Mailing address
10105 74TH ST, SUITE 102, KENOSHA, WI 53142-7519
(262) 909-5685
(262) 925-8409
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
9488-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100073905
—
WI
01
—
2172877
PK
—
Enumeration date
11/22/2017
Last updated
07/19/2018
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